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July 21, 1989

Tuberculosis in the United States

JAMA. 1989;262(3):385-389. doi:10.1001/jama.1989.03430030073037

TUBERCULOSIS, the "captain of all men of death," had long seemed to be gradually losing its grip on the US population as fewer cases were reported each year. Even an increase in 1980 that was attributable to cases arising from the large influx of refugees from Kampuchea, Laos, and Vietnam1 seemed only to halt temporarily the steady decline in tuberculosis morbidity. As recently as 1984 it seemed that the 1990 objective for the nation of an annual risk of 8.0 per 100 000 population would be met.2 However, the expected downward trend was halted in 1985 and reversed in 1986 with the occurrence of the first increase in the number of indigenous tuberculosis cases since national reporting began in 1953.3,4

Since 1985 all states have provided individual reports to the Centers for Disease Control, Atlanta, on every case of tuberculosis reported in their jurisdictions. Before 1985, morbidity data